Final year > UKMLA > Flashcards

UKMLA Flashcards

(74 cards)

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1
Q

What causes a pan systolic, high pitched and blowing murmur?

A

Mitral regurgitation

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2
Q

Which murmur is high pitched and blowing in character and louder on inspiration?

A

tricuspid regurgitation

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3
Q

What murmur is mid-late diastolic?

A

mitral stenosis

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4
Q

Which murmur is early diastolic?

A

aortic regurgitation

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5
Q

L3 nerve root compression?

A

Sensory loss over anterior thigh
Weak hip flexion, knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test

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6
Q

L4 nerve root compression

A

Sensory loss anterior aspect of knee and medial malleolus
Weak knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test

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7
Q

L5 nerve root compression

A

Sensory loss dorsum of foot
Weakness in foot and big toe dorsiflexion
Reflexes intact
Positive sciatic nerve stretch test

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8
Q

S1 nerve root compression

A

Weakness in plantar flexion of foot
Reduced ankle reflex
Positive sciatic nerve stretch test
Sensory loss posterolateral aspect of leg and lateral aspect of foot

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9
Q

What are the RF for glaucoma?

A

hypermetropia (long-sightedness)
pupillary dilatation
lens growth associated with age

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10
Q

What are the investigations for glaucoma?

A

tonometry
gonioscopy

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11
Q

What is the definitive management of glaucoma?

A

laser peripheral iridotomy

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12
Q

What eye drops can you give in glaucoma?

A

pilocarpine - parasympathomimetic
timolol - beta blocker
acetazolamide (IV)

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13
Q

What is the presentation of herpes zoster ophthalmicus?

A

vesicular rash around eye
Hutchinson sign: rash on the tip or side of the nose

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14
Q

What is the management of herpes zoster opthalmicus?

A

oral antiviral
topical corticosteroid

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15
Q

What are some features of MND?

A

limb weakness
UMN+LMN
muscle wasting in small hand muscles
fasciculations

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16
Q

What is the management of nephrotic syndrome?

A
  • prednisolone
  • add immunosuppressive for severe or refractory cases
  • diuretics for peripheral oedema
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17
Q

How does BCC present?

A

mc type is nodular
sun exposed sites
pearly flesh coloured papule leading to an ulcerated lesion with a crater
slow growing

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18
Q

What is the treatment for postpartum thyroiditis?

A

propranolol

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19
Q

What medications do you stop in AKI?

A

NSAIDS
Aminoglycosides
ACE-i
ARB
Diuretics

may stop - metformin, lithium, digoxin

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20
Q

What are the first line treatments for diabetic neuropathy?

A

amitriptyline
duloxetine - eGFR <30
gabapentin
pregabalin

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21
Q

What is the management of gastroparesis?

A

metoclopramide
domperidone

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22
Q

What are the features of Parkinson’s?

A

bradykinesia
resting tremor
lead pipe rigidity

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23
Q

What is the management of INR 5.0-8.0
No bleeding

A

Withhold 1 or 2 doses of warfarin
Reduce subsequent maintenance dose

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24
Q

What is the management of INR 5.0-8.0
Minor bleeding

A

Stop warfarin
Give intravenous vitamin K 1-3mg
Restart when INR < 5.0

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25
What is the management of INR > 8.0 No bleeding
Stop warfarin Give vitamin K 1-5mg by mouth, using the intravenous preparation orally Repeat dose of vitamin K if INR still too high after 24 hours Restart when INR < 5.0
26
What is the management of INR > 8.0 Minor bleeding
Stop warfarin Give intravenous vitamin K 1-3mg Repeat dose of vitamin K if INR still too high after 24 hours Restart warfarin when INR < 5.0
27
What are the lab values for primary hyperparathyroidism?
raised calcium, low phosphate PTH may be raised or (inappropriately, given the raised calcium) normal
28
What are the lab values for CKD - secondary hyperPTH?
decreased calcium increased phosphate increased ALP increased PTH
29
What are the lab values for osteomalacia?
just increased ALP and PTH
30
What is the management of neuropathic bladder in MS?
ultrasound first to assess bladder emptying if significant residual volume → intermittent self-catheterisation if no significant residual volume → anticholinergics may improve urinary frequency
31
What medications are given to patients with MS for spasticity?
baclofen and gabapentin
32
What is the management of aortic stenosis?
asx - observe unless valvular gradient >40mmHg and with left ventricular systolic dysfunction symptomatic = valve replacement
33
What is the surgical management of aortic stenosis?
surgical AVR - young and low/medium risk transcatheter AVR - high operative risk balloon valvuloplasty - in kids with no aortic calcification and in adults with critical aortic stenosis who are not fit for valve replacement
34
What is the management of AR?
medical of any associated HF Aortic valve surgery - sx or asx who have LV systolic dysfunction
35
What is the management of mitral regurg?
medical management in acute case - nitrates, diuretics if severe - surgery 9maybe repair over replacement)
36
What is the management of mitral stenosis?
with Af - warfarin asx - monitor with echo SX - mitral balloon valvotomy first line mitral valve surgery if unsuitable
37
What are the nerve roots for median nerve?
C5-T1
38
What are the nerve roots for the ulnar nerve?
C8-T1
39
What are the nerve roots for radial nerve ?
C5 -T1
40
What is the dermatome of thumb and index finger?
C6
41
What is the dermatome for middle finger and palm of hand ?
C7
42
What is the dermatome for ring and little finger?
C8
43
What is the dermatome of genitalia?
S2-S3
44
How does carcinoid syndrome present?
flushing diarrhoea bronchospasm hypotensive pellagra can develop
45
What are the investigations and management for carcinoid syndrome?
urinary 5-HIAA management - somatostatin analogue - octreotide
46
How does phaeochromocytoma present?
hypertensive headaches palpitations anxiety
47
What is the investigation and management of phaeochromocytoma?
24hr urinary collection of metanephrines surgery - stabilised first with alpha blocker and then beta blocker
48
What is phase 0 of clinical trial?
Involves a very small number of participants and aim to assess how a drug behaves in the human body. Used to assess pharmacokinetics and pharmacodynamics. Phase 0 trials help in determining whether it is feasible to move on to further phases.
49
What is phase 1 of clinical trial?
Safety assessment Determines side-effects prior to larger studies. Conducted on healthy volunteers
50
What is phase 2 of clinical trial?
Assess efficacy Involves small number of patients affected by particular disease May be subdivided into IIa - assesses optimal dosing IIb - assesses efficacy
51
What is phase 3 of clinical trial?
Assess effectiveness Typically involves 100-1000's of people, often as part of a randomised controlled trial, comparing new treatment with established treatments
52
What is phase 4 of clinical trial?
IV Postmarketing surveillance Monitors for long-term effectiveness and side-effects
53
What is the mechanism of hyoscine butyl bromide?
muscarinic receptor antagonist
54
What is the mechanism of benzodiazepine?
GABA potentiator
55
What do you prescribe for pain in palliative care in mild and severe renal impairment (<30)?
oxycodone Fentanyl
56
In alcohol withdrawal when does a patient experience symptoms, seizures, tremens?
symptoms- 6-12 seizures - 36hours delirium tremens - 72hours
57
What is used for the treatment of hiccups in palliative care?
Chlorpromazine
58
What is measured in a case control study?
odds ratio
59
What is the treatment of pseudomonas aeruginosa ?
oral ciprofloxacin
60
What is the Z score adjusted for?
age gender ethnic factors
61
What statistical method is used to compare the means of two subjects?
Two sample t test
62
What is the treatment of vestibular neuronitis?
buccal, IM - prochlorperazine in severe cases a short oral prochlorperazine in less severe cases vestibular rehab are preferred treatment for chronic
63
What is the palliative care treatment for dyspnoea?
morphine
64
What is the management of preterm prelabour rupture of the membranes?
- admission for observation - oral erythromycin - antenatal corticosteroids especially before 34 weeks - consider IV magnesium sulphate for fetal neuroprotection if <30 weeks - delivery recommended at 37 weeks
65
What is the management of breech presentation?
<36 turn spontaneously At 36 weeks - ECV offered at 37weeks for multiparous women
66
What is the mechanism of tocolytics?
y ↓ Ca²⁺ entry, ↓ Ca²⁺ effect, or ↑ relaxation signalling (cAMP/cGMP)
67
What is the management of umbilical cord prolapse?
presenting part of the fetus may be pushed back into the uterus to avoid compression all fours tocolytics retrofilling the bladder
68
When do you surgically excise a fibroadenoma?
>3cm
69
When do you do a blood transfusion in sickle cell anaemia and an exchange transfusion?
blood transfusion indications include: severe or symptomatic anaemia, pregnancy, pre-operative do not rapidly reduce the percentage of Hb S containing cells exchange transfusion indications include: acute vaso-occlusive crisis (stroke, acute chest syndrome, multiorgan failure, splenic sequestration crisis rapidly reduce the percentage of Hb S containing cells
70
How will an ACL rupture present?
popping swelling initially
71
How will meniscus tear present?
knee gives way worse on straightening knee knee locking
72
What is the mechanism of mifepristone ?
Competitive antagonist at progesterone receptors
73
What is the mechanism of oxybutynin?
antimuscarinic (M3)
74
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